Laserfiche WebLink
SEP -25-2007 06:39 Service Station Systems 406 93H dbub r.ue <br />I/sono MIC13CIl I CrIMTAINMFNT <br />ANNUAL. 'I CJInGJVL. o r-vn,.,�...v..v.+•'-si <br />LiUSANG # : <br />teName:, T-0 <br />1 efaHv 6f'Sv�. <br />t'SL rt.t ) - i4d• Add(ess: fJ 41e <br />Test Company: ,SRin. <br />Technician: <br />Data r),_IL-02 <br />vabped-By: []Spill Bucket Manufacturer ®Industry Standard Engineer 00ther(Spadfy)ed <br />®Hydrostatic 00thar(8pacfry) <br />4est EgWp seta Used:Measurin Tape 'Equipment riesOlutinnl1 /Example <br />• 1fa- increments <br />Spill Box # Spill Box # cl Spill Box # �) spill Box # <br />Fill Vapor Fill Vapor Fill Vapor Fill Vapor <br />_ <br />Bucket Capacity in gallons: <br />S` i 5� <br />:57— j l <br />BuckeYDepth: <br />3 in. in, 13 in. in. <br />y 3 in.• in. in. in. <br />Walt time between tiling with <br />w�terand slartin9 tesC <br />� min. J'— min, <br />r min. min. <br />Test Start Time: <br />% Z. +'r"I ( Z 0;4,i'- <br />-' <br />Initial Reading (RI): <br />/O in.1 in. /0 in.' in. <br />�n in in. in. in. <br />Test End Time: <br />Final Reading (RF):in.l <br />in.l in. eco in.: in. <br />v in.j in. n. <br />Test Duration: <br />% hr. hr. <br />% hr. hr. <br />Change in Reading (Ri- Air): <br />i <br />$- ; <br />l <br />as /Fail Threshold or Criteria: <br />Zero Loss Zero Loss <br />Zero Loss Zero Loss <br />.�•g"!5�+"t- <br />"a1 ,KSI;. _ 2 Fad P�a�l: <br />ail ass�a,l ,Pass Fa]I' Fass Fail <br />Spill Box # Spill Box # <br />spill Box # Spill Box # <br />'1 <br />Fill Vapor Fill Vapor <br />Fill vapor Fill ', Vapor <br />Bucket Capacity in gallons: <br />Bucket Depth: <br />in. in. in.; in.1 <br />in.t in. in.j <br />Walt time between titling with <br />water and starting last: <br />min. min. <br />min. min. <br />Test Start Time: <br />Initial Reading (RI): <br />ind in.1 in.j in.1 <br />in.; in, in.; <br />Test End Time: <br />F7na1'Reading (Rp): <br />in.i in.1 in.1 in. <br />in.1 in. in.j <br />Test Duration: <br />hr. hr. <br />hr. hr. <br />Change In Reading (RI - RF): <br />I <br />Pass/Fail Threshold or Criteria: <br />Zero Loss Zero Loss <br />Zero Loss Zero Loss <br />:=� .a`ss <br />-~a, "'ss"0h''al_•Pas`s Fall <br />ass `s"1 <br />Pt�su�,tl .y.;,�;9 Pass ail Pass Pali <br />comments • (include information on repairs made prior to testing, and recommended follow-up for failed tests.) <br />TOTAL P.02 <br />